NPI | 1760168637 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: MA PA9549) |
Additional Taxonomies | 363A00000X Physician Assistant |
Enumeration Date | 2023-06-26 |
Last Update Date | 2023-12-28 |