NPI | 1407297971 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: MA PA6554) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: CT 002938) |
Enumeration Date | 2013-07-12 |
Last Update Date | 2021-06-28 |