NPI | 1609811033 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: MD C0001948) |
Additional Taxonomies | 207RA0401X Internal Medicine, Addiction Medicine (Licence: MD C0001948) |
207R00000X Internal Medicine (Licence: MD C0001948) | |
Enumeration Date | 2006-06-19 |
Last Update Date | 2014-01-03 |