NPI | 1295277598 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical |
Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: NY 020338) |
Enumeration Date | 2016-11-17 |
Last Update Date | 2024-06-10 |