NPI | 1447634316 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: VA 0110008092) |
Additional Taxonomies | 208000000X Pediatrics (Licence: VA 0110008092) |
2080P0207X Pediatrics, Pediatric Hematology-Oncology (Licence: VA 0110008092) | |
363A00000X Physician Assistant (Licence: WV 2729) | |
363AM0700X Physician Assistant, Medical (Licence: WA PA60709751) | |
Enumeration Date | 2015-07-10 |
Last Update Date | 2023-06-01 |