NPI | 1831664846 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: PA OA006175) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA MA060217) |
363AM0700X Physician Assistant, Medical (Licence: PA MA060217) | |
Enumeration Date | 2018-10-05 |
Last Update Date | 2022-08-17 |