NPI | 1699924761 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: NJ 25MP00201100) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: NJ 25MP0020110) |
Enumeration Date | 2008-09-15 |
Last Update Date | 2022-11-30 |