NPI | 1902560543 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: OR PA205770) |
Additional Taxonomies | 207RE0101X Internal Medicine, Endocrinology, Diabetes & Metabolism (Licence: OR PA205770) |
363A00000X Physician Assistant | |
Enumeration Date | 2021-10-29 |
Last Update Date | 2022-01-18 |