NPI | 1932742764 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: NJ 25MP00550900) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical |
Enumeration Date | 2019-10-24 |
Last Update Date | 2023-03-28 |