NPI | 1710157300 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: MA PA2311) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: MA AP2311) |
Enumeration Date | 2008-03-10 |
Last Update Date | 2025-07-02 |