NPI | 1043349400 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: AZ 3474) |
Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: AZ 3474) |
Enumeration Date | 2007-03-03 |
Last Update Date | 2023-03-31 |