NPI | 1104587039 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: NY 028024) |
Additional Taxonomies | 363A00000X Physician Assistant |
Enumeration Date | 2022-01-03 |
Last Update Date | 2022-12-20 |