NPI | 1447714704 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 0010-11800) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: IL 085010470) |
363A00000X Physician Assistant (Licence: TN 3788) | |
Enumeration Date | 2019-01-30 |
Last Update Date | 2024-11-06 |