NPI | 1396126330 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: VA 0110005013) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: WV 2078) |
Enumeration Date | 2015-06-16 |
Last Update Date | 2023-03-07 |