NPI | 1144227489 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: PA MA051113) |
Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: PA MA051113) |
Enumeration Date | 2005-07-01 |
Last Update Date | 2025-01-08 |