NPI | 1508107657 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: VA 0110007265) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical |
Enumeration Date | 2013-03-13 |
Last Update Date | 2024-10-29 |