NPI | 1770237950 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: GA 11211) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: TN 4972) |
363AM0700X Physician Assistant, Medical (Licence: TN 4972) | |
Enumeration Date | 2022-02-07 |
Last Update Date | 2023-10-20 |