NPI | 1255388930 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 001008632) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: OH 50000765) |
363A00000X Physician Assistant (Licence: KS 1501132) | |
Enumeration Date | 2006-05-28 |
Last Update Date | 2023-02-20 |