NPI | 1396997110 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: SC TL3251) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: VA 0110003081) |
363A00000X Physician Assistant (Licence: DC PA030560) | |
Enumeration Date | 2008-10-13 |
Last Update Date | 2019-06-17 |