NPI | 1619457876 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA 60606) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA OA004584) |
363A00000X Physician Assistant (Licence: PA MA060037) | |
Enumeration Date | 2018-08-17 |
Last Update Date | 2024-05-28 |