NPI | 1255666574 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: MD C03454) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: DC PA03048) |
Enumeration Date | 2009-10-05 |
Last Update Date | 2009-10-05 |