NPI | 1871868646 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: MD C0004721) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: VA 0110003756) |
Enumeration Date | 2012-03-13 |
Last Update Date | 2021-08-31 |