NPI | 1700900834 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: VA 0110006720) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: DC PA030477) |
Enumeration Date | 2007-03-16 |
Last Update Date | 2024-03-06 |