NPI | 1790111797 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: NY 017013) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: NC 0010-05824) |
Enumeration Date | 2013-09-23 |
Last Update Date | 2023-09-26 |