NPI | 1801361654 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: CT 6445) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: FL PAT9111690) |
363A00000X Physician Assistant (Licence: FL 9111690) | |
Enumeration Date | 2018-10-08 |
Last Update Date | 2024-08-22 |