NPI | 1467655506 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: MO 2019003486) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: KS 15-00840) |
Enumeration Date | 2007-06-07 |
Last Update Date | 2020-04-02 |