NPI | 1699076877 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9113311) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: NJ 25MP00246800) |
Enumeration Date | 2010-11-04 |
Last Update Date | 2022-03-28 |