NPI | 1316456478 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: SC LL2830) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: SC 2830) |
Enumeration Date | 2017-09-21 |
Last Update Date | 2025-05-14 |