NPI | 1114152329 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: PA MAO55689) |
Additional Taxonomies | 163WM0705X Registered Nurse, Medical-Surgical (Licence: MD R185137) |
Enumeration Date | 2009-05-18 |
Last Update Date | 2013-09-27 |