NPI | 1962174284 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: CT 5572) |
Enumeration Date | 2021-10-05 |
Last Update Date | 2022-02-10 |