NPI | 1215412309 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9111539) |
Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: FL 9111539) |
Enumeration Date | 2018-09-25 |
Last Update Date | 2023-01-18 |