NPI | 1669760690 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9107718) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 014737) |
Enumeration Date | 2011-07-11 |
Last Update Date | 2021-03-24 |