NPI | 1376563924 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 104189) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: TN PA0961) |
363A00000X Physician Assistant (Licence: GA 4331) | |
Enumeration Date | 2006-07-19 |
Last Update Date | 2012-08-10 |