NPI | 1316264161 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: MO 2011041482) |
Additional Taxonomies | 363A00000X Physician Assistant |
Enumeration Date | 2010-05-03 |
Last Update Date | 2023-05-01 |