NPI | 1407281538 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: WV 01760) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: AL 1825) |
Enumeration Date | 2013-09-09 |
Last Update Date | 2021-10-01 |