NPI | 1912373317 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: WA PA60943083) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: DC PA031168) |
363A00000X Physician Assistant (Licence: CA 54396) | |
Enumeration Date | 2015-08-19 |
Last Update Date | 2022-05-10 |