NPI | 1942748272 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: AL PA-1266) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: GA 008260) |
Enumeration Date | 2017-02-07 |
Last Update Date | 2017-10-18 |