NPI | 1467533596 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: CA 18448) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: NY 009862-1) |
Enumeration Date | 2006-10-17 |
Last Update Date | 2007-07-08 |