NPI | 1912472325 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: AZ 7556) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical |
Enumeration Date | 2018-10-11 |
Last Update Date | 2024-03-08 |