NPI | 1417496803 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: PA MA058856) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: PA MA058856) |
Enumeration Date | 2017-02-17 |
Last Update Date | 2022-07-21 |