NPI | 1316298581 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: VT 055.0031275) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 015919) |
Enumeration Date | 2012-09-27 |
Last Update Date | 2015-12-17 |