NPI | 1578912424 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: VA 0110005892) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: MD C06236) |
Enumeration Date | 2016-06-10 |
Last Update Date | 2018-03-17 |