NPI | 1164629580 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: OR PA169442) |
Enumeration Date | 2007-06-29 |
Last Update Date | 2022-04-08 |