NPI | 1821530593 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: NJ 25MP00537700) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 020268) |
Enumeration Date | 2016-11-13 |
Last Update Date | 2024-05-28 |