NPI | 1346661329 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: NY 017091) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: NJ 25MP00324500) |
Enumeration Date | 2013-12-18 |
Last Update Date | 2020-11-03 |