NPI | 1164674164 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 0010-02291) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: MT 548) |
Enumeration Date | 2008-10-21 |
Last Update Date | 2014-05-18 |