NPI | 1003445636 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: OR PA221505) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: NC 0010-09843) |
Enumeration Date | 2020-04-06 |
Last Update Date | 2024-09-18 |