NPI | 1497283907 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: CT 4724) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: CA 54428) |
363A00000X Physician Assistant (Licence: NY 022392) | |
Enumeration Date | 2017-05-28 |
Last Update Date | 2024-11-13 |