NPI | 1821424292 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: PA MA056440) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: NJ 25MP00318400) |
Enumeration Date | 2013-09-17 |
Last Update Date | 2023-06-07 |