NPI | 1760723522 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: NE 2388) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: CO PA0005373) |
363A00000X Physician Assistant (Licence: WA PA60325568) | |
Enumeration Date | 2013-03-04 |
Last Update Date | 2024-07-12 |