NPI | 1144500968 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: CA 21408) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: CA PA21408) |
Enumeration Date | 2011-08-24 |
Last Update Date | 2018-08-29 |