NPI | 1033251186 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: NC 0010-01761) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: FL PA 9103738) |
363AM0700X Physician Assistant, Medical (Licence: MA 2378) | |
Enumeration Date | 2007-02-13 |
Last Update Date | 2020-04-24 |