NPI | 1760631279 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: PA MA053571) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: NJ 25MP00879200) |
Enumeration Date | 2008-09-09 |
Last Update Date | 2024-09-17 |