NPI | 1720395908 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: NY 031214) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: AZ 4679) |
363AM0700X Physician Assistant, Medical (Licence: AZ 4679) | |
Enumeration Date | 2010-09-09 |
Last Update Date | 2024-07-08 |