NPI | 1588122501 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: SC 3169) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: NC 0010-11616) |
Enumeration Date | 2019-03-08 |
Last Update Date | 2022-10-26 |