NPI | 1033462569 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: HI AMD-529) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: AZ 5287) |
Enumeration Date | 2012-10-22 |
Last Update Date | 2014-03-06 |