NPI | 1396055471 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: DC PA30037) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: VA 0110840738) |
363AM0700X Physician Assistant, Medical (Licence: MD C0003131) | |
Enumeration Date | 2010-10-07 |
Last Update Date | 2010-10-07 |