NPI | 1609887694 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: VI 0110001216) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: MD 0110001216) |
Enumeration Date | 2006-08-11 |
Last Update Date | 2012-02-09 |