NPI | 1346524691 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: CA PA22664) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: PA MA055167) |
Enumeration Date | 2011-10-05 |
Last Update Date | 2018-03-23 |