NPI | 1174143416 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: MA PA7505) |
Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: CT 4818) |
Enumeration Date | 2020-04-16 |
Last Update Date | 2022-04-22 |