NPI | 1760066468 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: NY 027214) |
Additional Taxonomies | 363A00000X Physician Assistant |
Enumeration Date | 2021-05-08 |
Last Update Date | 2025-07-08 |