NPI | 1982915823 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: MA PA3990) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: MA PA3990) |
363AS0400X Physician Assistant, Surgical (Licence: MA PA3990) | |
Enumeration Date | 2010-06-25 |
Last Update Date | 2013-11-25 |