NPI | 1316318777 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: MD C06480) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: VA 0110-005121) |
Enumeration Date | 2015-10-12 |
Last Update Date | 2022-07-21 |