NPI | 1780613018 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: WA PA10004690) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: OR PA159129) |
363A00000X Physician Assistant (Licence: AZ 7072) | |
363AM0700X Physician Assistant, Medical (Licence: WA PA10004690) | |
363AS0400X Physician Assistant, Surgical (Licence: WA PA10004690) | |
Enumeration Date | 2006-06-30 |
Last Update Date | 2024-10-21 |