NPI | 1629054333 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: WA PA10005176) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: AK AK333) |
Enumeration Date | 2005-12-15 |
Last Update Date | 2007-08-08 |