NPI | 1073381331 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: PA MA065275) |
Additional Taxonomies | 363A00000X Physician Assistant |
Enumeration Date | 2023-12-18 |
Last Update Date | 2024-01-25 |