NPI | 1952919417 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: NJ 25MP00568000) |
Additional Taxonomies | 363A00000X Physician Assistant |
Enumeration Date | 2020-07-21 |
Last Update Date | 2020-09-29 |