NPI | 1336577543 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: CT 003010) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: CT 3010) |
Enumeration Date | 2013-10-24 |
Last Update Date | 2019-05-22 |