NPI | 1518133032 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: CA PA21723) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: CO 2462) |
Enumeration Date | 2008-05-05 |
Last Update Date | 2017-08-01 |