NPI | 1669135968 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical |
Additional Taxonomies | 363AS0400X Physician Assistant, Surgical |
363A00000X Physician Assistant (Licence: NC 0010-11693) | |
Enumeration Date | 2021-10-14 |
Last Update Date | 2025-02-26 |