NPI | 1336621614 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: PA OA006452) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA MA060312) |
Enumeration Date | 2018-09-03 |
Last Update Date | 2023-05-25 |