NPI | 1912668468 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: MO 2023009272) |
Additional Taxonomies | 363A00000X Physician Assistant |
Enumeration Date | 2022-01-06 |
Last Update Date | 2023-04-06 |