NPI | 1275913907 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: PA MA057603) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA OA003849) |
363A00000X Physician Assistant (Licence: FL PA9115737) | |
Enumeration Date | 2015-06-08 |
Last Update Date | 2025-01-29 |