NPI | 1144646977 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: PA MA056750) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: PA OA003260) |
Enumeration Date | 2014-03-18 |
Last Update Date | 2023-06-07 |