NPI | 1649576950 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9115356) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 014582) |
Enumeration Date | 2011-02-03 |
Last Update Date | 2022-01-10 |