NPI | 1619249950 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: VA 0110004520) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: MD C05299) |
Enumeration Date | 2012-02-02 |
Last Update Date | 2014-06-02 |