NPI | 1255867552 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: ID PA-1519) |
Additional Taxonomies | 363A00000X Physician Assistant |
Enumeration Date | 2017-05-05 |
Last Update Date | 2023-12-13 |