NPI | 1295348811 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: SC 3668) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: SC 3668) |
363A00000X Physician Assistant (Licence: VA 0110010017) | |
363A00000X Physician Assistant (Licence: NC 0010-12557) | |
Enumeration Date | 2020-08-24 |
Last Update Date | 2025-03-25 |