NPI | 1477949899 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: KS 15-01797) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: OK 2460) |
Enumeration Date | 2015-04-13 |
Last Update Date | 2018-12-05 |