NPI | 1124031737 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: CT 001545) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: CT 001545) |
Enumeration Date | 2006-08-14 |
Last Update Date | 2013-10-02 |