NPI | 1689333429 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: MA PA101474) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: CT 5321) |
Enumeration Date | 2021-12-09 |
Last Update Date | 2025-05-12 |