NPI | 1669489233 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: NY 015404-1) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: VT 055-0030719) |
Enumeration Date | 2006-08-03 |
Last Update Date | 2012-01-11 |