NPI | 1134603277 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: DC PA031521) |
Additional Taxonomies | 363A00000X Physician Assistant |
363A00000X Physician Assistant (Licence: DC PA031521) | |
Enumeration Date | 2018-09-24 |
Last Update Date | 2022-12-22 |