NPI | 1184694713 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: TN 1697) |
Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: MI MN001411) |
Enumeration Date | 2006-01-25 |
Last Update Date | 2009-02-09 |