NPI | 1720658404 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: NJ 25MP00641900) |
Additional Taxonomies | 363A00000X Physician Assistant |
Enumeration Date | 2021-06-25 |
Last Update Date | 2024-02-26 |