NPI | 1962966309 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: WA PA61338992) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: CA 56420) |
363A00000X Physician Assistant | |
Enumeration Date | 2019-01-30 |
Last Update Date | 2024-06-06 |