NPI | 1336759109 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 0010-10613) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: NC 0010-10613) |
Enumeration Date | 2020-08-05 |
Last Update Date | 2024-03-11 |