NPI | 1578867842 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: WA PA60516096) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: AK 5877) |
Enumeration Date | 2010-12-30 |
Last Update Date | 2015-01-21 |