NPI | 1972042653 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: TN 3202) |
Enumeration Date | 2017-02-15 |
Last Update Date | 2025-06-25 |