NPI | 1275253296 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: NY 028772) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical |
363AM0700X Physician Assistant, Medical (Licence: NY 28772) | |
Enumeration Date | 2022-08-30 |
Last Update Date | 2023-07-22 |