NPI | 1235417734 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: PA MA054952) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: PA OA002671) |
Enumeration Date | 2011-08-01 |
Last Update Date | 2018-01-24 |