NPI | 1003829706 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: LA PA.A10316) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: LA PA. A10316.Rx) |
Enumeration Date | 2006-08-14 |
Last Update Date | 2023-01-10 |