NPI | 1124436621 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: PA MA056937) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: DC PA031190) |
Enumeration Date | 2014-07-28 |
Last Update Date | 2021-05-24 |