NPI | 1942592324 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 0010-02854) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: NC 0010-02854) |
Enumeration Date | 2011-05-04 |
Last Update Date | 2023-10-31 |