NPI | 1407232390 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: NY 019955) |
Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: CT 003357) |
Enumeration Date | 2015-08-03 |
Last Update Date | 2017-11-03 |