NPI | 1184214199 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: VA 0110007729) |
Additional Taxonomies | 363A00000X Physician Assistant |
Enumeration Date | 2021-01-23 |
Last Update Date | 2024-03-26 |