NPI | 1497170005 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: WA PA61473287) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: CA 55380) |
Enumeration Date | 2014-02-19 |
Last Update Date | 2024-03-20 |