NPI | 1750796561 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: GA 7170) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: GA 7170) |
Enumeration Date | 2014-07-01 |
Last Update Date | 2021-05-24 |