NPI | 1013361112 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA PA60463) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: TX PA10411) |
363A00000X Physician Assistant (Licence: NE 2234) | |
Enumeration Date | 2016-04-15 |
Last Update Date | 2022-10-13 |