NPI | 1760682397 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: PA MA052971) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 013025-1) |
146L00000X Emergency Medical Technician, Paramedic (Licence: PA 055431) | |
146L00000X Emergency Medical Technician, Paramedic (Licence: OH 0101920) | |
225700000X Massage Therapist (Licence: PA MSG001428) | |
Enumeration Date | 2007-07-22 |
Last Update Date | 2011-08-14 |