NPI | 1366965774 |
---|---|
Former Name | CHRISTY SIM |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant Medical (Licence: NY 021054) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: VA 0110008563) |
Enumeration Date | 2017-07-18 |
Last Update Date | 2024-05-14 |