NPI | 1457656704 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: GA 7265) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: OK 1991) |
Enumeration Date | 2011-01-18 |
Last Update Date | 2016-04-18 |