NPI | 1497172555 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: ID PA-1156) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: OR PA181966) |
Enumeration Date | 2014-03-26 |
Last Update Date | 2020-09-22 |