NPI | 1740324003 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: PA MA002456L) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: PA MA002456L) |
Enumeration Date | 2007-02-19 |
Last Update Date | 2022-10-17 |