NPI | 1407430549 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: VA 0110008085) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA MA062367) |
363A00000X Physician Assistant (Licence: PA OA005610) | |
Enumeration Date | 2021-05-05 |
Last Update Date | 2023-11-13 |