NPI | 1154363802 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: NV PA0436) |
Additional Taxonomies | 363AM0700X Physician Assistant Medical (Licence: PA MA051884) |
Enumeration Date | 2006-06-10 |
Last Update Date | 2019-06-24 |