NPI | 1205480803 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: SC 3351) |
Additional Taxonomies | 363A00000X Physician Assistant |
363AS0400X Physician Assistant, Surgical (Licence: SC PA3351) | |
Enumeration Date | 2019-07-31 |
Last Update Date | 2020-10-21 |