NPI | 1720496227 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: DE C5-0000952) |
Additional Taxonomies | 363AM0700X Physician Assistant Medical (Licence: DE C5-0000952) |
363AM0700X Physician Assistant Medical (Licence: MD C0005420) | |
Enumeration Date | 2014-07-28 |
Last Update Date | 2023-11-22 |