NPI | 1497212906 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: VA 0110006613) |
Additional Taxonomies | 363A00000X Physician Assistant |
Enumeration Date | 2019-02-21 |
Last Update Date | 2020-10-26 |