NPI | 1851939078 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: DE C5-0011531) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA 190962488) |
363A00000X Physician Assistant (Licence: PA 190962286) | |
Enumeration Date | 2019-12-18 |
Last Update Date | 2021-04-21 |