NPI | 1194384362 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: FL PA9112245) |
Additional Taxonomies | 363A00000X Physician Assistant |
Enumeration Date | 2019-06-11 |
Last Update Date | 2019-11-13 |