NPI | 1619711603 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363A00000X Physician Assistant |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 031960) |
Enumeration Date | 2024-06-24 |
Last Update Date | 2025-01-24 |