NPI | 1558199695 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: NJ 25MP00883000) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical |
Enumeration Date | 2024-07-22 |
Last Update Date | 2025-01-02 |