NPI | 1174920524 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: PA MA056961) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA OA003440) |
Enumeration Date | 2014-12-01 |
Last Update Date | 2015-12-24 |