NPI | 1326520792 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: MA PA8890) |
Additional Taxonomies | 363A00000X Physician Assistant |
Enumeration Date | 2018-09-03 |
Last Update Date | 2023-06-01 |