NPI | 1053502666 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: GA 6060) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: MA 2372) |
Enumeration Date | 2007-08-08 |
Last Update Date | 2015-01-19 |