NPI | 1841672037 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: RI PA01476) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: WA PA60947805) |
Enumeration Date | 2015-06-24 |
Last Update Date | 2022-08-03 |