NPI | 1174752752 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: PA MA063599) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: MA PA3804) |
Enumeration Date | 2009-07-05 |
Last Update Date | 2024-03-12 |