NPI | 1043769326 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: NY 020181) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: TX PA15983) |
Enumeration Date | 2016-09-27 |
Last Update Date | 2025-02-17 |