NPI | 1013639632 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: NY 031892) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: MA PA8977) |
363AS0400X Physician Assistant, Surgical | |
363AS0400X Physician Assistant, Surgical (Licence: NY 031892) | |
Enumeration Date | 2022-09-12 |
Last Update Date | 2024-11-07 |