NPI | 1962166504 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: TN 4772) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: GA 10698) |
Enumeration Date | 2021-10-29 |
Last Update Date | 2024-11-07 |