NPI | 1467798165 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: PA OA002979) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA MA0055938) |
Enumeration Date | 2012-12-27 |
Last Update Date | 2019-02-05 |