NPI | 1922357086 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: NY 015905) |
Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: CT 004549) |
Enumeration Date | 2012-09-05 |
Last Update Date | 2021-04-15 |