NPI | 1548563695 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA 60109) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 014531) |
Enumeration Date | 2010-12-13 |
Last Update Date | 2023-06-28 |