NPI | 1942637103 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: AZ 5493) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: NY 016897-1) |
Enumeration Date | 2013-10-02 |
Last Update Date | 2025-05-13 |