NPI | 1023634565 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: CT 4835) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: CT 4835) |
Enumeration Date | 2020-06-21 |
Last Update Date | 2020-07-10 |