NPI | 1467606913 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA PA20936) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: NJ 25mp00208500) |
Enumeration Date | 2008-11-11 |
Last Update Date | 2019-12-13 |