NPI | 1710181714 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: LA PA.200255) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: FL PA9110923) |
363A00000X Physician Assistant (Licence: AL PA.1523) | |
Enumeration Date | 2007-06-13 |
Last Update Date | 2019-12-16 |