NPI | 1013257385 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: FL PA9107110) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: FL PA9107110) |
Enumeration Date | 2013-02-25 |
Last Update Date | 2020-08-05 |