NPI | 1639731011 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: MA PA7112) |
Enumeration Date | 2019-07-05 |
Last Update Date | 2021-07-01 |