NPI | 1588049183 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: MA PA5553) |
Additional Taxonomies | 363A00000X Physician Assistant |
Enumeration Date | 2015-07-23 |
Last Update Date | 2022-02-07 |