NPI | 1609385194 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA PA61816) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: FL PA9116833) |
363A00000X Physician Assistant (Licence: MO 2023021119) | |
363A00000X Physician Assistant (Licence: TN 0000003458) | |
363A00000X Physician Assistant (Licence: GA 11796) | |
Enumeration Date | 2017-09-27 |
Last Update Date | 2025-01-17 |