NPI | 1922732999 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: NY 032368) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: NJ 25MP00867100) |
Enumeration Date | 2022-07-14 |
Last Update Date | 2025-04-17 |