NPI | 1215921911 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: VA 0110006233) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: VA 0110006233) |
Enumeration Date | 2005-09-08 |
Last Update Date | 2021-08-02 |