NPI | 1013080464 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL 9113754) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: DE C5-0000655) |
Enumeration Date | 2006-11-15 |
Last Update Date | 2023-12-29 |