NPI | 1639393291 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: CT 002140) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: NJ 25MP00072700) |
363AM0700X Physician Assistant, Medical (Licence: NJ 25MP00072700) | |
363AM0700X Physician Assistant, Medical (Licence: CT 002140) | |
Enumeration Date | 2007-04-12 |
Last Update Date | 2009-03-17 |