NPI | 1548775802 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: NY 024537-01) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: NJ 25MP00458100) |
Enumeration Date | 2017-12-08 |
Last Update Date | 2023-04-26 |