NPI | 1316763618 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: VA 0110010652) |
Additional Taxonomies | 363A00000X Physician Assistant |
Enumeration Date | 2024-12-02 |
Last Update Date | 2025-03-05 |