NPI | 1700544178 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: PA MA062719) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA OA005755) |
Enumeration Date | 2021-12-02 |
Last Update Date | 2021-12-02 |