NPI | 1356991251 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 0010-09505) |
Additional Taxonomies | 363A00000X Physician Assistant |
363A00000X Physician Assistant (Licence: NV PA2688) | |
Enumeration Date | 2019-09-13 |
Last Update Date | 2025-03-28 |