NPI | 1205099785 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: MA PA2554) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: MA AP2554) |
Enumeration Date | 2008-07-06 |
Last Update Date | 2019-01-30 |