NPI | 1922338920 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: GA 1090605) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: UT 141935738906) |
363A00000X Physician Assistant (Licence: NC 001005454) | |
Enumeration Date | 2010-01-13 |
Last Update Date | 2024-12-12 |