NPI | 1851682579 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: MD C0004442) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: DC PA030730) |
Enumeration Date | 2011-04-28 |
Last Update Date | 2022-07-21 |