NPI | 1326779596 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: MA PA9247) |
Additional Taxonomies | 363A00000X Physician Assistant |
Enumeration Date | 2022-06-20 |
Last Update Date | 2023-11-15 |