NPI | 1942632971 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: NJ 25MP00464200) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 016770) |
Enumeration Date | 2013-08-01 |
Last Update Date | 2023-03-07 |