NPI | 1699134254 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA 57573) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 019314) |
Enumeration Date | 2016-02-10 |
Last Update Date | 2021-07-12 |