NPI | 1083861918 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: PA MA053493) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: VA 0110003172) |
363A00000X Physician Assistant (Licence: DC PA030651) | |
Enumeration Date | 2008-08-21 |
Last Update Date | 2021-01-16 |