NPI | 1952829582 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: AZ 6813) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: NV PA2666) |
Enumeration Date | 2017-09-04 |
Last Update Date | 2023-12-12 |