NPI | 1689765943 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: MA 1053) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: CT 000880) |
Enumeration Date | 2006-09-28 |
Last Update Date | 2020-01-30 |