NPI | 1174294094 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: AZ 9592) |
Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: AZ 9592) |
Enumeration Date | 2021-09-21 |
Last Update Date | 2023-08-22 |