NPI | 1033774062 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: ME PA2459) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: FL 9112181) |
Enumeration Date | 2019-05-06 |
Last Update Date | 2023-07-18 |