NPI | 1972089969 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: MA PA7394) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: IA 092825) |
Enumeration Date | 2018-07-13 |
Last Update Date | 2021-01-15 |