NPI | 1578868329 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA PA22658) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: GA 2140) |
363AM0700X Physician Assistant, Medical (Licence: GA 006044) | |
Enumeration Date | 2011-01-25 |
Last Update Date | 2013-08-12 |