NPI | 1508001397 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: DE C5-0000947) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: MD C0003782) |
Enumeration Date | 2008-12-08 |
Last Update Date | 2015-01-05 |