NPI | 1235145905 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: NY 004180-1) |
Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: NY F300536-1) |
Enumeration Date | 2006-08-01 |
Last Update Date | 2009-12-18 |