NPI | 1306198445 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: PA MA057006) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 016113) |
Enumeration Date | 2012-10-14 |
Last Update Date | 2014-10-23 |