NPI | 1609470830 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: GA 13119) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: LA 327712) |
Enumeration Date | 2020-11-29 |
Last Update Date | 2025-06-06 |