NPI | 1265527626 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: PA MA 053800) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: PA OA002338) |
Enumeration Date | 2006-10-03 |
Last Update Date | 2023-04-17 |