NPI | 1811368632 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA 54410) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: FL PA9109047) |
Enumeration Date | 2015-10-20 |
Last Update Date | 2022-06-03 |