NPI | 1457092025 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: LA 333914) |
Additional Taxonomies | 363A00000X Physician Assistant |
Enumeration Date | 2022-04-06 |
Last Update Date | 2024-06-12 |