NPI | 1255061735 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: AL PA.2419) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: PA MA063530) |
Enumeration Date | 2022-06-16 |
Last Update Date | 2024-08-02 |