NPI | 1053740290 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: ID PA-1121) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: ID PA-1121) |
Enumeration Date | 2013-11-07 |
Last Update Date | 2021-11-08 |