NPI | 1932694239 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: AZ 10408) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: GA 9188) |
363A00000X Physician Assistant (Licence: AK 212514) | |
Enumeration Date | 2018-06-28 |
Last Update Date | 2024-10-14 |