NPI | 1386800258 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: VA 0110002422) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: MD C0003428) |
363AM0700X Physician Assistant, Medical (Licence: DC PA030459) | |
Enumeration Date | 2008-07-31 |
Last Update Date | 2024-04-04 |