NPI | 1235753740 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 25142) |
Enumeration Date | 2020-06-01 |
Last Update Date | 2023-07-03 |