NPI | 1962008441 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: CT 005098) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: CT 5098) |
Enumeration Date | 2020-12-09 |
Last Update Date | 2022-05-15 |