NPI | 1063702116 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA PA64279) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: CO PA.0006468) |
363A00000X Physician Assistant (Licence: NV PA0604) | |
363A00000X Physician Assistant (Licence: IL 085003971) | |
Enumeration Date | 2011-04-11 |
Last Update Date | 2024-10-10 |