NPI | 1598865115 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant Medical (Licence: VA 0110005339) |
Additional Taxonomies | 363A00000X Physician Assistant |
Enumeration Date | 2006-09-24 |
Last Update Date | 2024-07-23 |