NPI | 1265061899 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA 58397) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 028953) |
363A00000X Physician Assistant (Licence: MI 5601009917) | |
Enumeration Date | 2020-04-06 |
Last Update Date | 2024-08-16 |