NPI | 1528619111 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 001012879) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: CT 4606) |
Enumeration Date | 2019-09-25 |
Last Update Date | 2023-03-21 |