NPI | 1841268505 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: WA PA60217463) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: OR PA166690) |
363A00000X Physician Assistant (Licence: MN 10257) | |
363A00000X Physician Assistant (Licence: CO 2082) | |
363AM0700X Physician Assistant, Medical | |
Enumeration Date | 2006-03-09 |
Last Update Date | 2022-04-20 |