NPI | 1154897775 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: WA 60870737) |
Additional Taxonomies | 363AS0400X Physician Assistant, Surgical |
Enumeration Date | 2018-10-22 |
Last Update Date | 2018-10-22 |