NPI | 1194703652 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant Medical (Licence: CA PA22228) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 018361) |
363AM0700X Physician Assistant Medical (Licence: CO 868) | |
363AM0700X Physician Assistant Medical (Licence: AK 638) | |
Enumeration Date | 2006-01-05 |
Last Update Date | 2015-01-12 |