NPI | 1417370586 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: WA PA60481562) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: VA 0110-004484) |
Enumeration Date | 2014-01-27 |
Last Update Date | 2021-03-31 |