NPI | 1477936847 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: VT 055.0031295) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: VT 055.0031295) |
Enumeration Date | 2015-07-03 |
Last Update Date | 2024-07-06 |