NPI | 1902811771 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: NY 017430-1) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: NJ 25MP00126700) |
Enumeration Date | 2006-07-30 |
Last Update Date | 2022-01-20 |