NPI | 1750322921 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: PA MA052111) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: PA MX003771) |
363A00000X Physician Assistant (Licence: PA OA000385L) | |
Enumeration Date | 2006-06-09 |
Last Update Date | 2022-07-21 |