NPI | 1063594224 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: GA 10453) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 009284) |
Enumeration Date | 2006-10-19 |
Last Update Date | 2022-12-27 |