NPI | 1215312962 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: CT 004213) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: MA PA5465) |
Enumeration Date | 2015-07-23 |
Last Update Date | 2022-09-12 |