NPI | 1720608631 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: DC PA031775) |
Additional Taxonomies | 363A00000X Physician Assistant |
363A00000X Physician Assistant (Licence: DC PA031775) | |
Enumeration Date | 2020-04-21 |
Last Update Date | 2024-02-28 |