NPI | 1194180083 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363A00000X Physician Assistant |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: PA MA058037) |
Enumeration Date | 2015-12-21 |
Last Update Date | 2025-04-21 |