NPI | 1043942147 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: MA PA9574) |
363A00000X Physician Assistant | |
Enumeration Date | 2022-06-28 |
Last Update Date | 2023-09-13 |