NPI | 1285195768 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 0010-08883) |
Additional Taxonomies | 363AM0700X Physician Assistant Medical (Licence: NC 0010-08883) |
Enumeration Date | 2019-03-27 |
Last Update Date | 2023-10-30 |