NPI | 1619103272 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: LA 200295) |
Additional Taxonomies | 363A00000X Physician Assistant |
Enumeration Date | 2009-06-09 |
Last Update Date | 2020-12-28 |