NPI | 1780205484 |
---|---|
Former Name | BRIDGET MARY GALLAGHER |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: NJ 25MP00574800) |
Additional Taxonomies | 363A00000X Physician Assistant |
Enumeration Date | 2020-05-04 |
Last Update Date | 2023-07-21 |