NPI | 1033450192 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: DE C5-0000870) |
Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: DE C5-0000870) |
Enumeration Date | 2013-03-13 |
Last Update Date | 2021-10-08 |