NPI | 1770079774 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: IN 10002529A) |
Additional Taxonomies | 363A00000X Physician Assistant |
363AM0700X Physician Assistant, Medical (Licence: OK 4789) | |
Enumeration Date | 2018-07-03 |
Last Update Date | 2025-01-17 |