NPI | 1942785621 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant Medical (Licence: PA MA064481) |
Additional Taxonomies | 363AM0700X Physician Assistant Medical (Licence: NY 022644) |
Enumeration Date | 2018-09-28 |
Last Update Date | 2023-07-25 |