NPI | 1558777011 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: CT 3119) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: CT 003119) |
Enumeration Date | 2014-07-06 |
Last Update Date | 2019-04-22 |