NPI | 1043564701 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: OR PA165483) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA MA055837) |
Enumeration Date | 2012-11-02 |
Last Update Date | 2019-01-23 |