NPI | 1891148557 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: NY 019848-1) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: NY 19848) |
Enumeration Date | 2016-07-18 |
Last Update Date | 2023-06-29 |