NPI | 1902815004 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: WA PA 60115633) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: FL PA9103337) |
Enumeration Date | 2006-08-07 |
Last Update Date | 2012-05-02 |