NPI | 1124337050 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: MD C0004501) |
Additional Taxonomies | 363LP2300X Nurse Practitioner, Primary Care (Licence: NY 013555) |
Enumeration Date | 2010-09-27 |
Last Update Date | 2024-07-09 |