NPI | 1528317047 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA 51565) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 015907) |
Enumeration Date | 2012-08-29 |
Last Update Date | 2016-07-01 |