NPI | 1518290428 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: DE C5-0000830) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA MA053980) |
Enumeration Date | 2009-09-09 |
Last Update Date | 2017-11-10 |