NPI | 1720434897 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: NY 021232) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: FL PA 9109055) |
Enumeration Date | 2016-05-09 |
Last Update Date | 2020-12-16 |