NPI | 1730583436 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: SC 2184) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: FL PA9109424) |
Enumeration Date | 2014-10-09 |
Last Update Date | 2023-03-20 |