NPI | 1528469749 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: NC 0010-05798) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: NC 0010-05798) |
Enumeration Date | 2014-09-08 |
Last Update Date | 2022-11-21 |