NPI | 1124022165 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: AZ 2295) |
Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: AZ 2295) |
Enumeration Date | 2005-06-08 |
Last Update Date | 2020-01-29 |