NPI | 1396399671 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: DC PA200001491) |
Additional Taxonomies | 363A00000X Physician Assistant |
Enumeration Date | 2019-07-25 |
Last Update Date | 2022-07-09 |