NPI | 1386284115 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: AZ 10160) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: CA 59412) |
Enumeration Date | 2020-01-09 |
Last Update Date | 2024-02-05 |