NPI | 1841841590 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: MT MED-PAC-LIC-80060) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: MT 1168101) |
Enumeration Date | 2019-09-24 |
Last Update Date | 2022-03-21 |