NPI | 1841216785 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: MO 2001001417) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: GA 004050) |
207P00000X Emergency Medicine (Licence: MO 2001001417) | |
Enumeration Date | 2006-07-14 |
Last Update Date | 2008-10-29 |