NPI | 1922653526 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: LA 324953) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: MS PA00504) |
363A00000X Physician Assistant (Licence: TN PA5794) | |
Enumeration Date | 2019-08-09 |
Last Update Date | 2024-02-09 |