NPI | 1134716004 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: TN 6064) |
Additional Taxonomies | 246ZC0007X Specialist/Technologist, Other, Surgical Assistant (Licence: 196303) |
246ZC0007X Specialist/Technologist, Other, Surgical Assistant (Licence: 5151) | |
Enumeration Date | 2020-12-28 |
Last Update Date | 2024-06-26 |