NPI | 1730467143 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA PA55343) |
Additional Taxonomies | 208000000X Pediatrics (Licence: FL PA9105796) |
Enumeration Date | 2011-08-02 |
Last Update Date | 2020-10-01 |