NPI | 1689162406 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: DC PA031732) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: PA MA059716) |
Enumeration Date | 2018-04-26 |
Last Update Date | 2024-04-25 |