NPI | 1073259479 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: CA PA60727) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: CA PA60727) |
Enumeration Date | 2022-05-09 |
Last Update Date | 2023-10-10 |