NPI | 1710088612 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: VA 011002217) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: NY 004674) |
Enumeration Date | 2006-09-26 |
Last Update Date | 2020-04-10 |