NPI | 1497191175 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: SC 3056) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA MA056065) |
Enumeration Date | 2013-05-21 |
Last Update Date | 2022-03-01 |