NPI | 1538285077 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: NC 0010-06408) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: WV 01227) |
Enumeration Date | 2007-03-22 |
Last Update Date | 2025-10-02 |