NPI | 1699171694 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: SC PA2406) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: RI PA00784) |
363A00000X Physician Assistant (Licence: SC PA2406) | |
Enumeration Date | 2014-11-18 |
Last Update Date | 2024-05-13 |