NPI | 1265835581 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: MD C05861) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: AL PA.992) |
363AM0700X Physician Assistant, Medical (Licence: CA 59695) | |
363AM0700X Physician Assistant, Medical (Licence: VA 0110009818) | |
363AM0700X Physician Assistant, Medical (Licence: DC PA20001874) | |
Enumeration Date | 2014-10-01 |
Last Update Date | 2024-11-07 |