NPI | 1164712295 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: DE C5-0000501) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA MA051628) |
Enumeration Date | 2011-04-11 |
Last Update Date | 2017-01-11 |