NPI | 1275077182 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: PA MA058788) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA OA004014) |
Enumeration Date | 2016-12-12 |
Last Update Date | 2020-08-30 |