NPI | 1295882405 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9104165) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: SC A524-IM) |
Enumeration Date | 2007-01-03 |
Last Update Date | 2010-02-16 |