NPI | 1275729394 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: VA 0110004293) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: MD C03566) |
Enumeration Date | 2007-09-21 |
Last Update Date | 2016-04-22 |