NPI | 1003929613 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: MD C0001328) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: MD C0001328) |
Enumeration Date | 2006-08-16 |
Last Update Date | 2015-10-06 |