NPI | 1790755601 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 103295) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: NC 103295) |
Enumeration Date | 2006-01-24 |
Last Update Date | 2024-08-21 |