NPI | 1417460833 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: NY 085000243) |
Additional Taxonomies | 208D00000X General Practice (Licence: NY 085000243) |
363A00000X Physician Assistant (Licence: NY 085000243) | |
2083P0500X Preventive Medicine, Preventive Medicine/Occupational Environmental Medicine (Licence: NY 085000243) | |
363AM0700X Physician Assistant, Medical (Licence: IL 085000243) | |
Enumeration Date | 2017-11-07 |
Last Update Date | 2017-11-07 |