NPI | 1184000978 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363A00000X Physician Assistant |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: MA PA5541) |
Enumeration Date | 2015-08-04 |
Last Update Date | 2025-01-10 |