NPI | 1215583869 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: WV 2442) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: WV 2442) |
Enumeration Date | 2019-08-09 |
Last Update Date | 2022-11-10 |