NPI | 1073089116 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: CT 004286) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: CT 4286) |
Enumeration Date | 2018-10-16 |
Last Update Date | 2021-07-06 |