NPI | 1457751802 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: ID PA-1839) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: OR PA169153) |
363A00000X Physician Assistant (Licence: OR PG170101) | |
Enumeration Date | 2014-09-03 |
Last Update Date | 2023-02-08 |