NPI | 1306326897 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: SC 3064) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: NV PA2021-0010) |
363A00000X Physician Assistant (Licence: AZ 10272) | |
363A00000X Physician Assistant (Licence: VA 0110009327) | |
363AM0700X Physician Assistant, Medical | |
Enumeration Date | 2018-08-15 |
Last Update Date | 2024-06-19 |