NPI | 1063151249 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: AZ 9250) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: WA PA61477339) |
Enumeration Date | 2022-06-03 |
Last Update Date | 2024-08-30 |