NPI | 1518934751 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: OR PA158680) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: WA PA10004938) |
Enumeration Date | 2006-03-07 |
Last Update Date | 2017-02-20 |