NPI | 1841509973 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: WI 3717-23) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: MN 1489) |
Enumeration Date | 2010-10-07 |
Last Update Date | 2016-02-23 |