NPI | 1205419520 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 0010-11243) |
Additional Taxonomies | 363A00000X Physician Assistant |
Enumeration Date | 2021-05-04 |
Last Update Date | 2024-06-04 |