NPI | 1093481129 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: MT MED-PAC-LIC-112970) |
Additional Taxonomies | 363A00000X Physician Assistant |
Enumeration Date | 2021-08-18 |
Last Update Date | 2024-02-19 |