NPI | 1508307547 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: NJ 25MP00430900) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA MA058920) |
363A00000X Physician Assistant (Licence: PA OA004087) | |
Enumeration Date | 2017-03-09 |
Last Update Date | 2024-06-12 |