NPI | 1003847286 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: SC PA1068) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: NC 0010-00456) |
363AM0700X Physician Assistant, Medical (Licence: SC 1068) | |
363AM0700X Physician Assistant, Medical (Licence: NC 0010-00456) | |
Enumeration Date | 2006-07-05 |
Last Update Date | 2023-10-31 |