NPI | 1265711279 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: ME PA2248) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: RI PA00733) |
363A00000X Physician Assistant (Licence: CA PA21741) | |
Enumeration Date | 2011-08-08 |
Last Update Date | 2021-10-25 |