NPI | 1336827443 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: AZ 10456) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: PR 001696-P.A.) |
Enumeration Date | 2023-07-10 |
Last Update Date | 2024-09-12 |