NPI | 1346522612 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: VA 001001970) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA MA055129) |
363A00000X Physician Assistant (Licence: WV 1976) | |
Enumeration Date | 2011-09-13 |
Last Update Date | 2023-10-11 |