NPI | 1477804854 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: PA MA056858) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 016055) |
Enumeration Date | 2012-09-26 |
Last Update Date | 2015-01-01 |