NPI | 1942729363 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: AZ 7059) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: MI 5601010889) |
363A00000X Physician Assistant (Licence: NY 027862) | |
363A00000X Physician Assistant (Licence: CA 54863) | |
363A00000X Physician Assistant (Licence: FL PA9115386) | |
Enumeration Date | 2017-09-18 |
Last Update Date | 2022-08-16 |