NPI | 1114348331 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: MA PA5592) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: MD C0005162) |
Enumeration Date | 2013-12-16 |
Last Update Date | 2016-02-16 |