NPI | 1609246784 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: NY 019150) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 19150) |
Enumeration Date | 2015-10-01 |
Last Update Date | 2023-07-03 |