NPI | 1811557168 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: PA MA060693) |
Additional Taxonomies | 363A00000X Physician Assistant |
Enumeration Date | 2019-06-18 |
Last Update Date | 2021-01-11 |