NPI | 1134740640 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: AZ 8670) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: AZ 8670) |
363AS0400X Physician Assistant, Surgical (Licence: AZ 8670) | |
Enumeration Date | 2020-05-06 |
Last Update Date | 2024-05-15 |