NPI | 1871212332 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: CT 005925) |
Additional Taxonomies | 363A00000X Physician Assistant |
Enumeration Date | 2022-08-26 |
Last Update Date | 2022-12-11 |