NPI | 1609051192 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: CA PA 11484) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: FL PA 910903) |
Enumeration Date | 2008-01-03 |
Last Update Date | 2016-05-19 |