NPI | 1912994575 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: CT 001772) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: RI PA00340) |
363A00000X Physician Assistant (Licence: ME PA001240) | |
Enumeration Date | 2005-09-29 |
Last Update Date | 2014-05-22 |