NPI | 1558419739 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: NY 005044-1) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: NY 5044) |
Enumeration Date | 2007-01-06 |
Last Update Date | 2024-08-20 |