NPI | 1174175202 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: NC 0010-09204) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: NC 0010-09204) |
363A00000X Physician Assistant | |
Enumeration Date | 2019-07-09 |
Last Update Date | 2022-04-21 |