NPI | 1497000707 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: DC PA030333) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: MD C02916) |
Enumeration Date | 2012-07-24 |
Last Update Date | 2012-07-24 |