NPI | 1790110898 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: NE 1755) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: IA 002434) |
Enumeration Date | 2013-09-08 |
Last Update Date | 2023-05-10 |