NPI | 1932336195 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9111856) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 013114) |
Enumeration Date | 2009-06-16 |
Last Update Date | 2022-10-11 |