NPI | 1962005231 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: IN 10004188A) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: KY TC116) |
Enumeration Date | 2020-11-19 |
Last Update Date | 2024-12-26 |