NPI | 1295778504 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA PA19797) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: RI PA 00346) |
363A00000X Physician Assistant (Licence: NY 012972) | |
Enumeration Date | 2006-06-14 |
Last Update Date | 2016-05-19 |