NPI | 1831643725 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: LA 329209) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: CA 53607) |
Enumeration Date | 2016-08-08 |
Last Update Date | 2022-08-23 |