NPI | 1053413385 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: DC PA200001743) |
363AM0700X Physician Assistant, Medical (Licence: MD C0009044) | |
363AM0700X Physician Assistant, Medical (Licence: VA 0110002230) | |
Enumeration Date | 2006-09-05 |
Last Update Date | 2025-04-02 |