NPI | 1528452208 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363A00000X Physician Assistant |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical |
171000000X Military Health Care Provider | |
Enumeration Date | 2015-03-20 |
Last Update Date | 2023-11-01 |