NPI | 1811278906 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: NJ 25MP00265700) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: NJ 25MP00265700) |
Enumeration Date | 2011-09-01 |
Last Update Date | 2015-06-04 |