NPI | 1902373095 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: MS PA00673) |
Additional Taxonomies | 363A00000X Physician Assistant |
363A00000X Physician Assistant (Licence: CA PA56628) | |
207Q00000X Family Medicine (Licence: CA PA56628) | |
363AM0700X Physician Assistant, Medical (Licence: CA PA56628) | |
Enumeration Date | 2018-10-27 |
Last Update Date | 2022-09-26 |