NPI | 1932695764 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: PA MA063837) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: AZ 7130) |
363AM0700X Physician Assistant, Medical (Licence: MD C07208) | |
Enumeration Date | 2018-07-04 |
Last Update Date | 2022-10-07 |