NPI | 1639273246 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant Medical (Licence: VT 0550030955) |
Additional Taxonomies | 363AM0700X Physician Assistant Medical (Licence: VT 0550030954) |
Enumeration Date | 2006-09-12 |
Last Update Date | 2010-06-01 |