NPI | 1407302060 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: PA MA058391) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA OA003860) |
Enumeration Date | 2016-09-01 |
Last Update Date | 2019-12-01 |