NPI | 1811965254 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant Medical (Licence: NM PA2008-0033) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 008335) |
363AM0700X Physician Assistant Medical (Licence: AZ 4181) | |
Enumeration Date | 2006-03-10 |
Last Update Date | 2013-04-26 |