NPI | 1700559770 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: AZ 11121) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: LA 328191) |
Enumeration Date | 2021-07-27 |
Last Update Date | 2025-07-14 |