NPI | 1134643182 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: AZ 8870) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: CA 54701) |
Enumeration Date | 2017-08-01 |
Last Update Date | 2022-01-21 |