NPI | 1659620052 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA PA54439) |
Additional Taxonomies | 363A00000X Physician Assistant |
363AM0700X Physician Assistant, Medical (Licence: TX PA07931) | |
Enumeration Date | 2012-08-31 |
Last Update Date | 2022-07-21 |