NPI | 1730331265 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: NJ 25MP00486700) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: PA MA053678) |
Enumeration Date | 2008-10-15 |
Last Update Date | 2018-10-01 |