NPI | 1235218702 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: AZ 5096) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: UT 5740755-1206) |
Enumeration Date | 2006-11-03 |
Last Update Date | 2018-06-11 |