Rachael Theresa Detore Valid NPI

Individual provider · Physician Assistant · Wayne, NJ

NPI

1982154589

Type

Individual (Type 1)

Primary specialty

Physician Assistant

Specialty group

Physician Assistants & Advanced Practice Nursing Providers

Taxonomy code

363A00000X

License number

25MP00878300 (NJ)

Sex

Female

Sole proprietor

Yes

Enumerated

2016-10-06

Last updated

2024-10-25