NPI | 1578969481 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: VA 0110004780) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: MD C0005612) |
Enumeration Date | 2014-11-05 |
Last Update Date | 2022-03-28 |