NPI | 1396055216 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: AZ 4740) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: TX PA10233) |
Enumeration Date | 2010-10-13 |
Last Update Date | 2017-02-02 |