NPI | 1316506918 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: PA MA060783) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA OA005448) |
Enumeration Date | 2019-06-07 |
Last Update Date | 2022-11-30 |