NPI | 1821151309 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA PA55546) |
Additional Taxonomies | 2084A0401X Psychiatry & Neurology, Addiction Medicine (Licence: OR 153507) |
363A00000X Physician Assistant (Licence: OR PA 153507) | |
363A00000X Physician Assistant (Licence: WA PA60026556) | |
363A00000X Physician Assistant (Licence: NC 001000727) | |
Enumeration Date | 2006-12-18 |
Last Update Date | 2023-10-23 |