NPI | 1164646014 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 139762) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: MD C0001973) |
363A00000X Physician Assistant (Licence: DC PA030316) | |
Enumeration Date | 2007-04-12 |
Last Update Date | 2011-05-02 |