NPI | 1457742249 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: CA 53514) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: OR PA171206) |
Enumeration Date | 2015-02-15 |
Last Update Date | 2020-02-19 |