NPI | 1578686671 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: NJ 25MP00102200) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: NJ 25MP00102200) |
Enumeration Date | 2007-04-06 |
Last Update Date | 2016-12-29 |