NPI | 1336220383 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: PA MA002312L) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: NY 0057681) |
Enumeration Date | 2006-10-18 |
Last Update Date | 2023-10-11 |