NPI | 1982254173 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: PA MA060993) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: NY 027863) |
Enumeration Date | 2019-09-19 |
Last Update Date | 2024-04-30 |