NPI | 1871965129 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: DE C5-0011790) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: MA PA5513) |
Enumeration Date | 2015-10-27 |
Last Update Date | 2022-10-25 |