NPI | 1083082838 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 0010-12764) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: TN 2837) |
Enumeration Date | 2015-09-10 |
Last Update Date | 2023-03-09 |