NPI | 1184269912 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9118026) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: NY 024405) |
Enumeration Date | 2019-11-15 |
Last Update Date | 2024-03-08 |