NPI | 1265983522 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: PA MA058625) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: PA OA003954) |
Enumeration Date | 2016-10-20 |
Last Update Date | 2023-10-23 |