NPI | 1447576541 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: OR PA155839) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: WA PA60120252) |
Enumeration Date | 2010-04-14 |
Last Update Date | 2016-05-05 |