NPI | 1184101735 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: FL PA9111438) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical |
Enumeration Date | 2018-07-26 |
Last Update Date | 2024-11-20 |