NPI | 1932457405 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: DE C5-0012198) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: MD C0006806) |
363A00000X Physician Assistant (Licence: WA PA60663086) | |
Enumeration Date | 2012-08-15 |
Last Update Date | 2025-02-12 |