NPI | 1154050003 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: KS 15-02693) |
Additional Taxonomies | 363A00000X Physician Assistant |
Enumeration Date | 2022-06-07 |
Last Update Date | 2022-10-31 |