NPI | 1629873419 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: SC 5750) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: TN 6427) |
Enumeration Date | 2025-02-15 |
Last Update Date | 2025-07-22 |