NPI | 1518450931 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363A00000X Physician Assistant |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: OR PA00517) |
Enumeration Date | 2018-06-11 |
Last Update Date | 2018-06-16 |