NPI | 1851481725 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: OR PA03176) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: IL 85002846) |
Enumeration Date | 2006-10-13 |
Last Update Date | 2008-09-08 |