NPI | 1700042280 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: VT 055-0031178) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: AZ 4222) |
Enumeration Date | 2008-08-04 |
Last Update Date | 2017-01-12 |