NPI | 1073895132 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9107904) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: FL 000000000) |
Enumeration Date | 2011-09-15 |
Last Update Date | 2020-06-10 |