NPI | 1346673456 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: MD C06396) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: NY 016782-1) |
Enumeration Date | 2013-08-12 |
Last Update Date | 2021-09-28 |