NPI | 1558086280 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363AM0700X Physician Assistant Medical (Licence: DC PA200001553) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: DC PA200001553) |
Enumeration Date | 2022-10-05 |
Last Update Date | 2022-12-02 |