NPI | 1770245912 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: MA PA9015) |
Additional Taxonomies | 363A00000X Physician Assistant |
Enumeration Date | 2021-10-05 |
Last Update Date | 2022-11-03 |