NPI | 1043460645 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: VA 0110009228) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: CA 15380) |
Enumeration Date | 2008-09-19 |
Last Update Date | 2025-06-12 |