NPI | 1023135902 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA PA15278) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: CA 15278) |
363AS0400X Physician Assistant, Surgical (Licence: CA 15278) | |
Enumeration Date | 2007-03-23 |
Last Update Date | 2019-07-30 |