NPI | 1174130421 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA 64865) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: WI 7126) |
Enumeration Date | 2020-09-29 |
Last Update Date | 2024-09-13 |