NPI | 1831264365 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: NJ 25MP00146900) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: PA MA051331) |
Enumeration Date | 2006-11-21 |
Last Update Date | 2024-04-09 |