NPI | 1528493400 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: NC 0010-04481) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: NC 0010-04481) |
Enumeration Date | 2013-09-10 |
Last Update Date | 2020-10-21 |