NPI | 1659937456 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: OR PA213429) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: NY 23973) |
363A00000X Physician Assistant | |
Enumeration Date | 2019-05-16 |
Last Update Date | 2023-07-17 |