NPI | 1497388821 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: DE C5-0011636) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: NJ 25MP00560300) |
Enumeration Date | 2020-02-13 |
Last Update Date | 2024-09-03 |