NPI | 1699121244 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: NH 1819) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: MA 5724) |
Enumeration Date | 2016-05-12 |
Last Update Date | 2022-06-28 |