NPI | 1831707330 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: WI 5560) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: KY TC958) |
363AM0700X Physician Assistant, Medical (Licence: KY TC958) | |
363AS0400X Physician Assistant, Surgical (Licence: KY TC958) | |
Enumeration Date | 2020-07-21 |
Last Update Date | 2022-03-02 |