NPI | 1972194850 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: VA 0110009285) |
Additional Taxonomies | 208800000X Urology (Licence: VA 0110009285) |
363A00000X Physician Assistant | |
Enumeration Date | 2021-02-02 |
Last Update Date | 2023-08-11 |