NPI | 1831832120 |
---|---|
Former Name | ELIZABETH RUTH MARTIN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: NJ 25MP00787000) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: VA 0110008586) |
363A00000X Physician Assistant | |
Enumeration Date | 2022-04-15 |
Last Update Date | 2025-06-17 |