NPI | 1184667164 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: ID PA-1144) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: NM PA2008-0013) |
Enumeration Date | 2006-06-14 |
Last Update Date | 2021-11-09 |