NPI | 1588801708 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: MA PA3942) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical |
363AS0400X Physician Assistant, Surgical (Licence: MA PA3942) | |
Enumeration Date | 2009-01-09 |
Last Update Date | 2019-02-26 |