NPI | 1053717850 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: GA 7331) |
Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: GA 7331) |
363AM0700X Physician Assistant, Medical (Licence: GA 7331) | |
Enumeration Date | 2014-11-06 |
Last Update Date | 2024-08-22 |