NPI | 1366078065 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA 10000) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: DC PA031753) |
363A00000X Physician Assistant (Licence: VA 0110-007125) | |
Enumeration Date | 2020-03-13 |
Last Update Date | 2023-10-31 |