NPI | 1306197819 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA PA22326) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: NM PA2012-0041) |
Enumeration Date | 2012-09-24 |
Last Update Date | 2019-08-07 |