NPI | 1578784070 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: MO 2010011175) |
Additional Taxonomies | 363A00000X Physician Assistant |
Enumeration Date | 2007-05-01 |
Last Update Date | 2021-06-02 |