NPI | 1245654920 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363A00000X Physician Assistant |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: NY 017368) |
Enumeration Date | 2014-02-14 |
Last Update Date | 2025-07-07 |