NPI | 1215418207 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AS0400X Physician Assistant Surgical (Licence: AZ 7475) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: KY TC739) |
Enumeration Date | 2018-08-27 |
Last Update Date | 2019-08-20 |