NPI | 1962096636 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: OR PA218896) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: NV PA2408) |
Enumeration Date | 2021-02-23 |
Last Update Date | 2024-03-25 |