NPI | 1588962815 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: NE 1583) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: IA 002187) |
Enumeration Date | 2011-03-10 |
Last Update Date | 2014-09-10 |