NPI | 1174174452 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: PA MA065859) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: WA PA60833836) |
Enumeration Date | 2019-09-27 |
Last Update Date | 2024-09-06 |