NPI | 1447754767 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: OR PA224228) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: MO 2018009238) |
Enumeration Date | 2018-03-21 |
Last Update Date | 2025-06-09 |