NPI | 1255995411 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: SC 3360) |
Additional Taxonomies | 363A00000X Physician Assistant |
Enumeration Date | 2019-04-23 |
Last Update Date | 2023-02-06 |