NPI | 1023232659 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA PA20191) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 011750) |
Enumeration Date | 2007-04-13 |
Last Update Date | 2010-09-14 |