NPI | 1184976565 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: VA 0110004748) |
Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: VA 0110004748) |
Enumeration Date | 2012-10-09 |
Last Update Date | 2020-04-23 |