NPI | 1396330767 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: PA MA062037) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA OA006467) |
Enumeration Date | 2021-03-07 |
Last Update Date | 2024-01-26 |