NPI | 1588640221 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: NM 92-PA17) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: NM R10041) |
207Q00000X Family Medicine (Licence: NM 92-PA17) | |
Enumeration Date | 2005-12-15 |
Last Update Date | 2012-01-17 |