NPI | 1710963103 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: WV 825) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: WV 00825) |
Enumeration Date | 2005-12-19 |
Last Update Date | 2020-12-04 |