NPI | 1588623326 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: LA PA.200040) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: AL PA474) |
Enumeration Date | 2006-03-21 |
Last Update Date | 2015-11-09 |