NPI | 1487136461 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: MT 77899) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: SD 1155) |
Enumeration Date | 2018-09-05 |
Last Update Date | 2021-11-11 |