NPI | 1215932272 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA PA15047) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: CA PA15047) |
Enumeration Date | 2005-06-16 |
Last Update Date | 2021-01-15 |