NPI | 1396286902 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: MD C06415) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: VA 0110005571) |
Enumeration Date | 2017-03-15 |
Last Update Date | 2023-06-22 |