NPI | 1982617387 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: IN 10000858A) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: FL PA9105820) |
363A00000X Physician Assistant (Licence: KY PA1182) | |
Enumeration Date | 2006-08-15 |
Last Update Date | 2020-12-28 |