NPI | 1215457940 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: NY 020944-1) |
Additional Taxonomies | 363A00000X Physician Assistant |
363A00000X Physician Assistant (Licence: NJ 25MP00439500) | |
363AM0700X Physician Assistant, Medical | |
Enumeration Date | 2017-06-23 |
Last Update Date | 2023-09-21 |