NPI | 1982390282 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: WV 870) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: FL 9117743) |
Enumeration Date | 2023-04-11 |
Last Update Date | 2023-09-07 |