NPI | 1831640770 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: PA MA059857) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: PA MX040035) |
363AM0700X Physician Assistant, Medical (Licence: PA OA004509) | |
363AM0700X Physician Assistant, Medical (Licence: PA MR4937922) | |
Enumeration Date | 2016-10-15 |
Last Update Date | 2025-07-09 |