NPI | 1134755937 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: VA 0110007274) |
Additional Taxonomies | 363A00000X Physician Assistant |
Enumeration Date | 2020-03-12 |
Last Update Date | 2023-09-13 |