NPI | 1740302413 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA 53220) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 23011812) |
Enumeration Date | 2007-04-04 |
Last Update Date | 2019-06-10 |