NPI | 1689262586 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: MD C0007869) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA MA062169) |
363A00000X Physician Assistant (Licence: PA OA005451) | |
Enumeration Date | 2021-01-06 |
Last Update Date | 2021-03-10 |