NPI | 1104333178 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant |
Additional Taxonomies | 164W00000X Licensed Practical Nurse (Licence: NY 329541-1) |
Enumeration Date | 2017-12-29 |
Last Update Date | 2023-01-21 |