NPI | 1629018825 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: NJ 25MP00088300) |
Additional Taxonomies | 363A00000X Physician Assistant |
Enumeration Date | 2006-06-07 |
Last Update Date | 2024-09-20 |