NPI | 1467878264 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA 57514) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: NE 1811) |
Enumeration Date | 2014-03-17 |
Last Update Date | 2021-07-31 |