NPI | 1730539669 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: NY 027890-01) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: MI 5601002384) |
Enumeration Date | 2016-06-22 |
Last Update Date | 2023-08-18 |