NPI | 1649640814 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: NV PA1641) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: CA 52441) |
Enumeration Date | 2015-09-30 |
Last Update Date | 2024-09-10 |