NPI | 1023635380 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: MO 2020027179) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: KS 1502351) |
Enumeration Date | 2020-07-01 |
Last Update Date | 2024-06-18 |