NPI | 1255998134 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 0010-12962) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: NY 024505) |
Enumeration Date | 2019-05-25 |
Last Update Date | 2023-08-31 |