NPI | 1366221954 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: MD C0009083) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: MD C0009083) |
Enumeration Date | 2023-09-25 |
Last Update Date | 2024-06-28 |