NPI | 1649462664 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: NY 013604-1) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: NJ 25MP00184400) |
Enumeration Date | 2007-08-14 |
Last Update Date | 2009-11-27 |