NPI | 1902891278 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 103663) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: TN PA0000001143) |
Enumeration Date | 2005-09-13 |
Last Update Date | 2010-03-15 |