NPI | 1700323888 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA 60246) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 020585) |
363A00000X Physician Assistant (Licence: AZ 9234) | |
Enumeration Date | 2017-01-26 |
Last Update Date | 2024-01-29 |