NPI | 1679130025 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: CA 61218) |
363A00000X Physician Assistant (Licence: SC 5277) | |
363AM0700X Physician Assistant, Medical (Licence: GA 9511) | |
Enumeration Date | 2019-05-21 |
Last Update Date | 2024-08-28 |