NPI | 1295341618 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: NY 025655) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA MA061504) |
Enumeration Date | 2020-09-21 |
Last Update Date | 2022-03-04 |