NPI | 1104381060 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: VA 0110-006553) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: MD C0007442) |
Enumeration Date | 2019-02-05 |
Last Update Date | 2023-04-19 |