NPI | 1720633910 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 23964) |
Enumeration Date | 2019-08-05 |
Last Update Date | 2023-07-03 |