NPI | 1265067888 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: NY 031222) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
363A00000X Physician Assistant (Licence: ID PA-2173) | |
Enumeration Date | 2020-03-04 |
Last Update Date | 2024-10-22 |