NPI | 1134622368 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: MA PA6365) |
Additional Taxonomies | 363A00000X Physician Assistant |
Enumeration Date | 2018-03-14 |
Last Update Date | 2021-04-07 |