NPI | 1487061008 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: CT 003111) |
Enumeration Date | 2014-07-15 |
Last Update Date | 2017-06-26 |