NPI | 1093071706 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: SC 2248) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: GA 6356) |
Enumeration Date | 2012-04-06 |
Last Update Date | 2015-01-12 |