NPI | 1922521160 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: MA PA101749) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: FL 9115412) |
363A00000X Physician Assistant (Licence: NY 021021-1) | |
Enumeration Date | 2017-07-19 |
Last Update Date | 2025-09-25 |