NPI | 1689765950 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: DE C5-0000392) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: PA MA000376L) |
Enumeration Date | 2006-09-28 |
Last Update Date | 2007-07-08 |