NPI | 1053041871 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: LA 332890) |
Additional Taxonomies | 363A00000X Physician Assistant |
Enumeration Date | 2022-06-14 |
Last Update Date | 2022-09-21 |