NPI | 1891289914 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: NJ MK6383513) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: NJ MK6383513) |
363AS0400X Physician Assistant, Surgical (Licence: NY 022081) | |
363A00000X Physician Assistant (Licence: NY 022081) | |
Enumeration Date | 2018-06-21 |
Last Update Date | 2024-03-05 |