NPI | 1548875347 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA 61428) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: NY 025612) |
363A00000X Physician Assistant (Licence: NY 025612) | |
363AS0400X Physician Assistant, Surgical (Licence: NY 025612) | |
Enumeration Date | 2020-09-09 |
Last Update Date | 2023-10-25 |