NPI | 1184075301 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 0010-06489) |
Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: NC 0010-06489) |
Enumeration Date | 2016-06-29 |
Last Update Date | 2020-02-12 |