NPI | 1053373886 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: CA PA 14901) |
Additional Taxonomies | 207QA0505X Family Medicine, Adult Medicine (Licence: WA PA61306617) |
208D00000X General Practice (Licence: CA 14901) | |
Enumeration Date | 2006-04-05 |
Last Update Date | 2024-08-24 |