NPI | 1649676396 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: MA PA6032) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 018074) |
Enumeration Date | 2014-11-07 |
Last Update Date | 2021-03-30 |