NPI | 1851743066 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: NY 019789-1) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: NY 019789-1) |
Enumeration Date | 2016-07-12 |
Last Update Date | 2016-07-12 |