NPI | 1801411715 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: GA 9856) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: KY 1172186) |
Enumeration Date | 2020-06-16 |
Last Update Date | 2020-10-01 |