NPI | 1235957077 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: PA MA066034) |
Additional Taxonomies | 363AM0700X Physician Assistant Medical (Licence: PA MA066034) |
Enumeration Date | 2024-10-01 |
Last Update Date | 2024-10-01 |