NPI | 1891937280 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: NJ 25MP00008400) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: PA MA000896L) |
363AM0700X Physician Assistant, Medical (Licence: PA OA000016L) | |
Enumeration Date | 2009-03-31 |
Last Update Date | 2016-07-18 |