NPI | 1720642812 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA 63080) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: MA PA7026) |
Enumeration Date | 2019-04-24 |
Last Update Date | 2024-06-10 |