NPI | 1215333406 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: OR PA208577) |
Additional Taxonomies | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: TX PA09389) |
2085R0204X Radiology, Vascular & Interventional Radiology (Licence: CA PA58062) | |
363A00000X Physician Assistant | |
363A00000X Physician Assistant (Licence: CA 58062) | |
363A00000X Physician Assistant (Licence: CA PA58062) | |
363AM0700X Physician Assistant, Medical (Licence: OR PA208577) | |
Enumeration Date | 2014-11-14 |
Last Update Date | 2024-11-07 |