NPI | 1639936164 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: NY 031429-01) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 031429) |
Enumeration Date | 2024-03-01 |
Last Update Date | 2024-06-12 |