NPI | 1922895374 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: NY 033684) |
Additional Taxonomies | 2080A0000X Pediatrics, Adolescent Medicine (Licence: NY 033684) |
Enumeration Date | 2025-04-21 |
Last Update Date | 2025-07-02 |