NPI | 1245949056 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: TN 5365) |
Additional Taxonomies | 363A00000X Physician Assistant |
Enumeration Date | 2022-11-21 |
Last Update Date | 2023-05-15 |