NPI | 1083678288 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: PA OA000716) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: PA MA050706) |
Enumeration Date | 2006-04-14 |
Last Update Date | 2023-08-29 |