NPI | 1225666555 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363AS0400X Physician Assistant, Surgical |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2020-03-31 |
Last Update Date | 2023-04-24 |