NPI | 1932773983 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: GA 10372) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: GA 10372) |
Enumeration Date | 2021-05-14 |
Last Update Date | 2023-02-02 |