NPI | 1295333466 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: CT 5708) |
Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NY 025734) |
Enumeration Date | 2020-10-11 |
Last Update Date | 2022-07-29 |