NPI | 1710642269 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 0010-11793) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical |
Enumeration Date | 2021-11-01 |
Last Update Date | 2023-01-11 |