NPI | 1003589409 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: CA 60017) |
363AS0400X Physician Assistant, Surgical (Licence: CA 60017) | |
Enumeration Date | 2021-07-30 |
Last Update Date | 2023-04-05 |