NPI | 1184510687 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: 1041618) |
Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: VA 0110001433) |
Enumeration Date | 2025-06-13 |
Last Update Date | 2025-06-24 |