NPI | 1194942474 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: VA 0110002690) |
Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: NY 010413-1) |
Enumeration Date | 2007-04-19 |
Last Update Date | 2009-02-15 |