NPI | 1245795921 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: GA 9168) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: VA 01100010322) |
363A00000X Physician Assistant | |
Enumeration Date | 2019-02-06 |
Last Update Date | 2025-01-13 |