NPI | 1053922880 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: ID PA-2137) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: ID 1189253) |
Enumeration Date | 2020-08-14 |
Last Update Date | 2023-08-22 |