NPI | 1104137900 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: NE 2496) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: NE 1102) |
363A00000X Physician Assistant (Licence: IA 002385) | |
363AM0700X Physician Assistant, Medical (Licence: IN 10001192A) | |
Enumeration Date | 2010-06-25 |
Last Update Date | 2020-07-27 |