NPI | 1922072065 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: MA 114) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: MA 114) |
Enumeration Date | 2006-02-15 |
Last Update Date | 2012-09-21 |