NPI | 1235445495 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: CA PA53291) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: NJ 25MP00243000) |
Enumeration Date | 2010-08-26 |
Last Update Date | 2022-07-21 |