NPI | 1912550245 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: PA oa004904) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA MA060728) |
Enumeration Date | 2019-07-16 |
Last Update Date | 2024-02-09 |