NPI | 1063752145 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: OR PA225266) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: TX P08222) |
363A00000X Physician Assistant (Licence: CA 63407) | |
Enumeration Date | 2013-02-26 |
Last Update Date | 2025-07-15 |