NPI | 1932503596 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: ID PA-1365) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: AZ 5753) |
Enumeration Date | 2014-10-10 |
Last Update Date | 2016-07-21 |