NPI | 1366116543 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA 60494) |
Additional Taxonomies | 363A00000X Physician Assistant |
363AM0700X Physician Assistant, Medical (Licence: CA 60494) | |
Enumeration Date | 2021-08-02 |
Last Update Date | 2022-01-19 |