NPI | 1952874240 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA 61000) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: OH 50.005831RX) |
363A00000X Physician Assistant (Licence: AZ 9490) | |
363A00000X Physician Assistant (Licence: TX PA17038) | |
Enumeration Date | 2019-01-09 |
Last Update Date | 2024-04-30 |