NPI | 1922651470 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: NJ 25MP00667200) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 023663-01) |
Enumeration Date | 2019-07-23 |
Last Update Date | 2024-05-08 |