NPI | 1861745374 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: NY 016147-1) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: NY 016147-1) |
Enumeration Date | 2012-10-22 |
Last Update Date | 2018-12-12 |