NPI | 1336500404 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: PA MA058147) |
Additional Taxonomies | 363A00000X Physician Assistant |
Enumeration Date | 2016-03-16 |
Last Update Date | 2022-05-11 |