NPI | 1982974556 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: SC 1804) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: NC 0010-03320) |
Enumeration Date | 2012-01-12 |
Last Update Date | 2016-08-10 |