NPI | 1396172557 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: WA PA60862943) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: CA PA23283) |
Enumeration Date | 2013-10-02 |
Last Update Date | 2021-01-25 |