NPI | 1225154313 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: MT MED-PAC-LIC-505) |
Additional Taxonomies | 363A00000X Physician Assistant |
Enumeration Date | 2007-03-21 |
Last Update Date | 2021-12-14 |