NPI | 1194913707 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: MD 1075400) |
Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: MD 1075400) |
Enumeration Date | 2007-10-09 |
Last Update Date | 2007-10-09 |