NPI | 1184174526 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: PA MA063741) |
Additional Taxonomies | 363AS0400X Physician Assistant Surgical |
Enumeration Date | 2016-10-10 |
Last Update Date | 2022-09-27 |