NPI | 1336496462 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: PA MA055519) |
Additional Taxonomies | 363AM0700X Physician Assistant Medical (Licence: PA MA055519) |
Enumeration Date | 2012-08-08 |
Last Update Date | 2023-11-10 |