NPI | 1639892995 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363A00000X Physician Assistant |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: MA PA100043) |
Enumeration Date | 2022-09-21 |
Last Update Date | 2025-10-02 |