NPI | 1821321266 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL 9105438) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 013493) |
363A00000X Physician Assistant (Licence: CT 2311) | |
Enumeration Date | 2009-09-17 |
Last Update Date | 2013-03-22 |