NPI | 1093182479 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: ID PA-1253) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: ID ID-1253) |
Enumeration Date | 2015-09-01 |
Last Update Date | 2024-05-21 |