NPI | 1295036440 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: CA PA66535) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: TN 5356) |
363AM0700X Physician Assistant, Medical (Licence: TX PA06803) | |
Enumeration Date | 2010-11-04 |
Last Update Date | 2025-09-25 |