NPI | 1750307690 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: VA 0110001514) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 005805) |
363A00000X Physician Assistant (Licence: NJ MP634) | |
207P00000X Emergency Medicine (Licence: VA 0110001514) | |
Enumeration Date | 2006-07-14 |
Last Update Date | 2010-12-13 |