NPI | 1043884778 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: PR 704PA) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: AZ 8515) |
Enumeration Date | 2021-05-17 |
Last Update Date | 2025-05-04 |