NPI | 1366719080 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: OK PA5503) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: CA PA22003) |
Enumeration Date | 2011-11-23 |
Last Update Date | 2024-12-26 |