NPI | 1437662194 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: MT MED-PAC-LIC-89261) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: CA PA54944) |
Enumeration Date | 2017-11-15 |
Last Update Date | 2025-04-09 |