NPI | 1376748285 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: MD C0004354) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: WY TL#508) |
Enumeration Date | 2007-06-19 |
Last Update Date | 2013-05-21 |