NPI | 1255660247 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: CT 3077) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: GA 005657) |
363AM0700X Physician Assistant, Medical (Licence: IL 085004279) | |
Enumeration Date | 2009-12-22 |
Last Update Date | 2015-06-26 |