NPI | 1053568006 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AS0400X Physician Assistant Surgical (Licence: CA PA 19802) |
Additional Taxonomies | 363AM0700X Physician Assistant Medical (Licence: CA PA 19802) |
Enumeration Date | 2008-08-21 |
Last Update Date | 2022-01-05 |