| NPI | 1760948780 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9118161) |
| Additional Taxonomies | 2471C3402X Radiologic Technologist, Radiography (Licence: NY 548239) |
| 363A00000X Physician Assistant (Licence: NY 023890) | |
| 247100000X Radiologic Technologist | |
| Enumeration Date | 2019-02-14 |
| Last Update Date | 2024-06-06 |