NPI | 1912410309 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: AZ 6790) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: AZ 6790) |
Enumeration Date | 2017-11-08 |
Last Update Date | 2023-12-04 |