NPI | 1225099773 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: VA 0110002394) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: NC 102771) |
Enumeration Date | 2006-03-31 |
Last Update Date | 2018-03-17 |