NPI | 1316243207 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: PA MA054829) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA MA054829) |
Enumeration Date | 2011-02-10 |
Last Update Date | 2022-04-05 |