NPI | 1558640011 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: PA MA058779) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 014920) |
Enumeration Date | 2011-08-15 |
Last Update Date | 2024-03-14 |