NPI | 1831803063 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: GA 11511) |
Additional Taxonomies | 363A00000X Physician Assistant |
Enumeration Date | 2023-01-11 |
Last Update Date | 2023-04-10 |