NPI | 1881001386 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: NJ 25MP00541100) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 23017739) |
363A00000X Physician Assistant (Licence: NJ 25MP00541100) | |
Enumeration Date | 2014-07-16 |
Last Update Date | 2025-05-19 |