NPI | 1083412332 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9120140) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: AL 1215677) |
Enumeration Date | 2025-03-04 |
Last Update Date | 2025-05-22 |