NPI | 1891753851 |
---|---|
Former Name | DARLENE LYNN FALTAS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: NJ 25MP000124800) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: NJ 25MP00124800) |
Enumeration Date | 2006-05-01 |
Last Update Date | 2017-12-14 |