NPI | 1588815195 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: PA MA053679) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: DE C5-0001058) |
Enumeration Date | 2008-10-02 |
Last Update Date | 2022-09-29 |