NPI | 1427505957 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363A00000X Physician Assistant |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 019895) |
Enumeration Date | 2016-09-01 |
Last Update Date | 2021-01-27 |