NPI | 1093352619 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: MD C0009503) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: FL PA9112672) |
Enumeration Date | 2019-12-02 |
Last Update Date | 2024-11-12 |