NPI | 1184306664 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: PA MA065057) |
Additional Taxonomies | 363A00000X Physician Assistant |
Enumeration Date | 2023-08-03 |
Last Update Date | 2024-02-29 |