NPI | 1760114466 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: MO 2022040146) |
Additional Taxonomies | 363A00000X Physician Assistant |
Enumeration Date | 2022-06-30 |
Last Update Date | 2022-11-23 |