NPI | 1821611732 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: TN 4255) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: VA 0110007447) |
Enumeration Date | 2020-05-26 |
Last Update Date | 2020-10-14 |