NPI | 1013429661 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: LA 306980) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: LA 306980) |
Enumeration Date | 2017-11-03 |
Last Update Date | 2020-11-11 |