NPI | 1285205906 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: MI 5601010705) |
Enumeration Date | 2021-07-03 |
Last Update Date | 2024-01-17 |