NPI | 1467905232 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: FL 9116683) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: NY 019721-1) |
Enumeration Date | 2016-07-28 |
Last Update Date | 2024-10-10 |