NPI | 1972126639 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: WI 5469) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: WI 5469) |
Enumeration Date | 2020-05-28 |
Last Update Date | 2022-10-21 |