NPI | 1093170235 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: MA PA101472) |
Additional Taxonomies | 363A00000X Physician Assistant |
Enumeration Date | 2015-12-15 |
Last Update Date | 2025-05-08 |