NPI | 1558678912 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: NY 014129) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: NY 014129) |
Enumeration Date | 2010-09-08 |
Last Update Date | 2010-09-08 |