NPI | 1477893741 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: PA MA055970) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 016339-1) |
Enumeration Date | 2013-02-25 |
Last Update Date | 2015-01-28 |