NPI | 1780840934 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: PA MA057349) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: VA 0110002822) |
363A00000X Physician Assistant (Licence: PA MA057349) | |
Enumeration Date | 2008-08-06 |
Last Update Date | 2016-09-14 |