NPI | 1174568109 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: NY 7084) |
363AM0700X Physician Assistant, Medical (Licence: NY 007084) | |
Enumeration Date | 2006-06-16 |
Last Update Date | 2023-03-21 |