NPI | 1275159287 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: VA 0110007742) |
Additional Taxonomies | 363A00000X Physician Assistant |
Enumeration Date | 2020-06-25 |
Last Update Date | 2021-07-21 |