NPI | 1356495907 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: MA PA5624) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: WA PA10003868) |
Enumeration Date | 2007-01-22 |
Last Update Date | 2016-12-13 |