NPI | 1558816249 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: PA MA061864) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: MA PA5767) |
Enumeration Date | 2016-08-23 |
Last Update Date | 2021-11-17 |