NPI | 1952530586 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: MD C0004763) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA TMA052087) |
363A00000X Physician Assistant (Licence: MD c00321) | |
Enumeration Date | 2009-07-02 |
Last Update Date | 2012-09-18 |