NPI | 1174557656 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: MD C0002665) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: MD C0002665) |
363AM0700X Physician Assistant, Medical (Licence: MD C0002665) | |
Enumeration Date | 2006-07-10 |
Last Update Date | 2019-07-08 |