NPI | 1245332337 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: WY 321) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: AZ 8722) |
363AM0700X Physician Assistant, Medical (Licence: WY md1123075) | |
Enumeration Date | 2006-09-01 |
Last Update Date | 2025-09-19 |