NPI | 1649287939 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: WY 475) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: NE 1071) |
Enumeration Date | 2006-08-01 |
Last Update Date | 2011-01-06 |