NPI | 1386137792 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: OR PA195775) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
363A00000X Physician Assistant | |
Enumeration Date | 2018-06-11 |
Last Update Date | 2022-06-16 |