NPI | 1053311084 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: ID PA421) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: OR PA00840) |
Enumeration Date | 2005-08-01 |
Last Update Date | 2011-02-16 |