NPI | 1720129380 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: NC 100774) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: NC 100774) |
Enumeration Date | 2007-02-08 |
Last Update Date | 2013-09-04 |