NPI | 1538439278 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: NJ 25MP00276500) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA MA055223) |
363AM0700X Physician Assistant, Medical | |
Enumeration Date | 2012-01-11 |
Last Update Date | 2017-05-12 |