NPI | 1184824005 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AS0400X Physician Assistant Surgical (Licence: UT 5744061-1206) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: MD C0003391) |
Enumeration Date | 2007-07-19 |
Last Update Date | 2008-03-26 |