NPI | 1326342072 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: CA PA61178) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: NY 012291) |
Enumeration Date | 2011-01-10 |
Last Update Date | 2022-09-29 |