NPI | 1871207928 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: MA PA9172) |
Additional Taxonomies | 363A00000X Physician Assistant |
Enumeration Date | 2023-01-12 |
Last Update Date | 2023-11-15 |