NPI | 1558023317 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: AZ 10477) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical |
363AM0700X Physician Assistant, Medical (Licence: NM PA2021-0115) | |
Enumeration Date | 2021-10-08 |
Last Update Date | 2024-08-15 |