NPI | 1346592169 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 001004291) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: VA 0110003998) |
Enumeration Date | 2012-10-03 |
Last Update Date | 2013-07-26 |