NPI | 1538413885 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: ME PA 1610) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: NJ 25MP00297100) |
Enumeration Date | 2012-11-07 |
Last Update Date | 2024-05-16 |