NPI | 1699944033 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363AM0700X Physician Assistant Medical (Licence: NJ 25MP00471900) |
Additional Taxonomies | 363AM0700X Physician Assistant Medical (Licence: NY 012389) |
363AM0700X Physician Assistant Medical (Licence: PA MA063671) | |
363AM0700X Physician Assistant Medical (Licence: FL PA9117706) | |
Enumeration Date | 2008-02-28 |
Last Update Date | 2025-07-24 |