NPI | 1487741468 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: VA 0110006858) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: DC 030445) |
363AM0700X Physician Assistant, Medical (Licence: GA 6532) | |
363AM0700X Physician Assistant, Medical (Licence: MD C03573) | |
Enumeration Date | 2006-10-09 |
Last Update Date | 2022-12-10 |