NPI | 1639506553 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: DE C5-0000912) |
363AM0700X Physician Assistant, Medical (Licence: DE C5-0000912) | |
Enumeration Date | 2013-10-09 |
Last Update Date | 2025-06-04 |