NPI | 1093084931 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: ID PA-1385) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: NY 016558) |
363AM0700X Physician Assistant, Medical (Licence: WA PA60650168) | |
363AM0700X Physician Assistant, Medical (Licence: PA OA003740) | |
Enumeration Date | 2011-12-21 |
Last Update Date | 2021-07-15 |