NPI | 1093797250 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: WA PA61092965) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: WA PA61092965) |
363A00000X Physician Assistant (Licence: WI 1164-023) | |
363AS0400X Physician Assistant, Surgical (Licence: WI 1164-023) | |
363AS0400X Physician Assistant, Surgical (Licence: CA 56266) | |
Enumeration Date | 2005-11-15 |
Last Update Date | 2020-12-18 |