NPI | 1568803096 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9112265) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: NY 016704) |
Enumeration Date | 2013-07-12 |
Last Update Date | 2022-08-05 |