NPI | 1609882752 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: VA 0110001425) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: VA 0110001425) |
Enumeration Date | 2006-07-31 |
Last Update Date | 2023-11-27 |