NPI | 1306665047 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: NY 032839) |
Additional Taxonomies | 363A00000X Physician Assistant |
Enumeration Date | 2024-10-09 |
Last Update Date | 2024-12-03 |