NPI | 1508404641 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: NY 026813) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: NY 026813) |
Enumeration Date | 2019-12-19 |
Last Update Date | 2021-10-14 |