NPI | 1972933661 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: NY 020780) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: PA MA056445) |
Enumeration Date | 2013-11-18 |
Last Update Date | 2018-03-21 |