NPI | 1093117491 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: LA PA.200760) |
Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: LA PA.200760) |
Enumeration Date | 2014-09-17 |
Last Update Date | 2014-09-17 |