NPI | 1225816648 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: PA MA065033) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA OA006637) |
Enumeration Date | 2023-09-18 |
Last Update Date | 2023-12-21 |