NPI | 1376698688 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 0010-00697) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: VA 0110002537) |
363A00000X Physician Assistant (Licence: OH 003803) | |
Enumeration Date | 2007-01-24 |
Last Update Date | 2016-12-09 |