NPI | 1437615853 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: VA 0110010847) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: TX PA12571) |
363A00000X Physician Assistant (Licence: MN 13472) | |
Enumeration Date | 2019-02-11 |
Last Update Date | 2025-08-11 |