NPI | 1003394545 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: PA PA9111440) |
Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: FL PA9111440) |
363AM0700X Physician Assistant, Medical | |
Enumeration Date | 2018-08-06 |
Last Update Date | 2020-10-01 |