NPI | 1649390667 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: AL PA522) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: GA 004738) |
Enumeration Date | 2007-03-31 |
Last Update Date | 2009-06-30 |