NPI | 1114434255 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: NC 0010-07795) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: AL PA.1500) |
363A00000X Physician Assistant (Licence: NC 001017795) | |
Enumeration Date | 2018-01-09 |
Last Update Date | 2024-10-09 |