NPI | 1700640679 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: AR PA-1257) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: AR PT2024-023) |
363A00000X Physician Assistant (Licence: AR PA-1257) | |
Enumeration Date | 2024-02-12 |
Last Update Date | 2024-09-23 |