NPI | 1851790232 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: SC 4010) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: NC 0010-09067) |
363AM0700X Physician Assistant, Medical (Licence: MD C05479) | |
Enumeration Date | 2014-08-21 |
Last Update Date | 2023-05-10 |