NPI | 1497263438 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: WA PA61018533) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: NV PA1931) |
Enumeration Date | 2018-01-11 |
Last Update Date | 2020-02-20 |