NPI | 1578828604 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA PA51811) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: WA PA60282936) |
363A00000X Physician Assistant (Licence: FL PA9114486) | |
Enumeration Date | 2012-07-04 |
Last Update Date | 2024-07-03 |