NPI | 1215498647 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: VA 0110006811) |
Enumeration Date | 2019-03-28 |
Last Update Date | 2025-08-07 |