NPI | 1881321198 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: ID 6761478) |
Additional Taxonomies | 2471C3401X Radiologic Technologist, Computed Tomography (Licence: ID 578041) |
Enumeration Date | 2022-08-05 |
Last Update Date | 2025-01-28 |