NPI | 1992410179 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: CT 6423) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: NC 0010-13133) |
Enumeration Date | 2023-01-23 |
Last Update Date | 2024-07-28 |