NPI | 1780853085 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: CO 2922) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: IL 085-003184) |
Enumeration Date | 2008-02-21 |
Last Update Date | 2009-11-03 |