NPI | 1669919577 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: NV PA0367) |
Additional Taxonomies | 363A00000X Physician Assistant |
363A00000X Physician Assistant (Licence: OH 50.004921RX) | |
Enumeration Date | 2017-01-30 |
Last Update Date | 2025-05-24 |