NPI | 1811397581 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: NY 017860-1) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: NY 017860) |
Enumeration Date | 2014-08-29 |
Last Update Date | 2023-09-18 |