NPI | 1639952302 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: PA MA064691) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical |
Enumeration Date | 2023-08-16 |
Last Update Date | 2024-05-07 |