NPI | 1235411745 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: NY 024584) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: FL PA92105567) |
Enumeration Date | 2011-09-12 |
Last Update Date | 2021-01-04 |