NPI | 1508221086 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: PA9113527) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA MA058009) |
Enumeration Date | 2015-12-28 |
Last Update Date | 2021-10-14 |