NPI | 1811489883 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: NE 2393) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: IA 092249) |
Enumeration Date | 2018-06-05 |
Last Update Date | 2021-08-24 |