NPI | 1497470686 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: VA 0110009943) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: CA PA61426) |
Enumeration Date | 2022-10-10 |
Last Update Date | 2024-07-23 |