NPI | 1013428705 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: MA PA9317) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: PA MA059268) |
Enumeration Date | 2017-10-20 |
Last Update Date | 2024-06-06 |