NPI | 1457781148 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: IA 082332) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: AZ 5589) |
Enumeration Date | 2013-11-18 |
Last Update Date | 2017-05-04 |