NPI | 1811948797 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: PA MAO53052) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: CA 21091) |
363A00000X Physician Assistant (Licence: PA OA000938) | |
Enumeration Date | 2006-05-15 |
Last Update Date | 2021-09-13 |