NPI | 1043617327 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: GA 6527) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: SC 2224) |
Enumeration Date | 2014-12-02 |
Last Update Date | 2023-11-28 |