NPI | 1861432163 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: OR 159703) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: GA 004679) |
363A00000X Physician Assistant (Licence: NM 2010-0006) | |
Enumeration Date | 2006-06-07 |
Last Update Date | 2015-05-21 |