NPI | 1023191574 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: VA 0110-002246) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: WV 1062) |
Enumeration Date | 2006-10-20 |
Last Update Date | 2008-11-13 |