NPI | 1356877328 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: CA PA62067) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: GA 008351) |
Enumeration Date | 2017-05-11 |
Last Update Date | 2023-03-14 |