NPI | 1043652142 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9114592) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: WA PA60630951) |
Enumeration Date | 2013-07-18 |
Last Update Date | 2021-10-05 |