NPI | 1073289781 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: PA MA062863) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA OA005808) |
Enumeration Date | 2021-08-22 |
Last Update Date | 2023-10-18 |