NPI | 1871811729 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: IA 002181) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: NE 1501) |
Enumeration Date | 2010-05-16 |
Last Update Date | 2016-06-08 |