NPI | 1295867919 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA PA-16300) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: FL 9101798) |
Enumeration Date | 2007-03-09 |
Last Update Date | 2007-07-08 |