NPI | 1093371759 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA 56608) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: IN 10002711A) |
363AM0700X Physician Assistant Medical (Licence: IN 10002711A) | |
363AS0400X Physician Assistant Surgical (Licence: TX PA15641) | |
Enumeration Date | 2019-05-17 |
Last Update Date | 2023-12-27 |