NPI | 1518696269 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: VA 0110009392) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical |
Enumeration Date | 2022-06-08 |
Last Update Date | 2025-04-22 |