NPI | 1194292193 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA 56642) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: NV PA2132) |
Enumeration Date | 2018-10-28 |
Last Update Date | 2024-10-30 |