NPI | 1922645514 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant |
Additional Taxonomies | 363AM0700X Physician Assistant Medical |
363AS0400X Physician Assistant Surgical | |
Enumeration Date | 2019-12-03 |
Last Update Date | 2022-06-08 |