NPI | 1043611957 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: NV PA1573) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: NV PA1573) |
Enumeration Date | 2014-09-10 |
Last Update Date | 2019-12-10 |