NPI | 1861467565 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: PA MA052085) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: NC 0010-00781) |
Enumeration Date | 2006-02-17 |
Last Update Date | 2012-05-01 |