NPI | 1417570235 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: GA 10485) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: NC 0010-11305) |
Enumeration Date | 2020-05-27 |
Last Update Date | 2022-06-06 |