NPI | 1245006147 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: CT 6374) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: NY 031018) |
Enumeration Date | 2023-11-30 |
Last Update Date | 2023-11-30 |