NPI | 1992079545 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: SC 1435) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: SC 1435) |
Enumeration Date | 2012-02-29 |
Last Update Date | 2019-06-11 |