NPI | 1356331060 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: OR PA162456) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: AZ 3180) |
Enumeration Date | 2005-10-24 |
Last Update Date | 2022-10-11 |