NPI | 1407121809 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: AZ 9606) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: UT 8241324-1206) |
Enumeration Date | 2012-03-19 |
Last Update Date | 2023-03-23 |