NPI | 1568767267 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: NM PA2011-0004) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: FL PA 9105626) |
Enumeration Date | 2011-01-11 |
Last Update Date | 2016-06-08 |