NPI | 1295326882 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: MO 2024038955) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: TX PA14271) |
363A00000X Physician Assistant (Licence: IL 085.010790) | |
363A00000X Physician Assistant (Licence: TN 6125) | |
Enumeration Date | 2021-01-27 |
Last Update Date | 2025-02-07 |