NPI | 1053748780 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 0010-12112) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: VA 0110004387) |
Enumeration Date | 2013-09-26 |
Last Update Date | 2024-11-19 |