NPI | 1710205521 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA 53266) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA MA054386) |
363A00000X Physician Assistant (Licence: NY 013708) | |
Enumeration Date | 2010-05-04 |
Last Update Date | 2024-02-06 |