NPI | 1114140910 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: ID PA1727) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: OR PA01197) |
363AS0400X Physician Assistant, Surgical (Licence: TX PA 03869) | |
Enumeration Date | 2007-04-10 |
Last Update Date | 2022-10-20 |