NPI | 1376538330 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: DE C5-0000692) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: MD C0004279) |
Enumeration Date | 2005-09-15 |
Last Update Date | 2017-04-12 |