NPI | 1225434798 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: OR PA174934) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: CA PA59660) |
Enumeration Date | 2014-11-11 |
Last Update Date | 2023-11-03 |