NPI | 1184712960 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: FL PA1621) |
Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: FL PA0001621) |
Enumeration Date | 2006-10-10 |
Last Update Date | 2012-01-04 |