NPI | 1073378055 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 0010-14002) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: NC 001014002) |
Enumeration Date | 2024-02-19 |
Last Update Date | 2024-06-28 |