NPI | 1225327794 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA 22782) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: NM PA2012-0063) |
363A00000X Physician Assistant (Licence: MI 5601012388) | |
Enumeration Date | 2011-04-05 |
Last Update Date | 2024-08-21 |