NPI | 1710547385 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: MA PA7139) |
Additional Taxonomies | 363A00000X Physician Assistant |
Enumeration Date | 2019-06-17 |
Last Update Date | 2024-06-27 |