NPI | 1720430622 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: NJ 25MP00450200) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: PA MA058211) |
Enumeration Date | 2016-07-05 |
Last Update Date | 2025-02-20 |